scholarly journals Child and adolescent mental health services in Pakistan: current situation, future directions and possible solutions

2008 ◽  
Vol 5 (4) ◽  
pp. 86-88 ◽  
Author(s):  
Faria Khan ◽  
R. K. Shehzad ◽  
Haroon R. Chaudhry

Worldwide, mental disorders are on the increase (Gadit, 2007) and an estimated 10-20% of children have one or more mental or behavioural problems (Park, 2002). There is an urgent and serious need to pay attention to the mental health needs of children in low- and middle-income countries (Rahman et al, 2000). The initial survey for the World Health Organization's Atlas project (Sherer, 2002) showed that 41% of countries surveyed had no mental health policy and 28% had no separate budget for mental health.

2014 ◽  
Vol 11 (1) ◽  
pp. 20-22
Author(s):  
Olufemi Oluwatayo ◽  
Olufemi Olugbile ◽  
Ayodele Coker

The Lagos State Government of Nigeria recently launched its Mental Health Policy and Work Plan aimed at addressing the mental health needs of Lagos, one of the world's fastest-growing megacities, and its nearby communities. This paper discusses the contextual basis of this initiative, its components and the challenges faced so far. It argues that urban centres deserve attention in the current push towards investing in mental health services in low- and middle-income countries.


2016 ◽  
Vol 3 ◽  
Author(s):  
C. L. H. Bockting ◽  
A. D. Williams ◽  
K. Carswell ◽  
A. E. Grech

The World Health Organization (WHO) reports that low- and middle-income countries (LMICs) are confronted with a serious ‘mental health gap’, indicating an enormous disparity between the number of individuals in need of mental health care and the availability of professionals to provide such care (WHO in 2010). Traditional forms of mental health services (i.e. face-to-face, individualised assessments and interventions) are therefore not feasible. We propose three strategies for addressing this mental health gap: delivery of evidence-based, low-intensity interventions by non-specialists, the use of transdiagnostic treatment protocols, and strategic deployment of technology to facilitate access and uptake. We urge researchers from all over the world to conduct feasibility studies and randomised controlled studies on the effect of low-intensity interventions and technology supported (e.g. online) interventions in LMICs, preferably using an active control condition as comparison, to ensure we disseminate effective treatments in LMICs.


2015 ◽  
Vol 12 (S1) ◽  
pp. S-16-S-19 ◽  
Author(s):  
Anne Aboaja ◽  
Puja Myles ◽  
Peter Hughes

This paper describes the evaluation of a pilot e-supervision programme, with a focus on feasibility. The findings suggest that e-supervision in mental health using the World Health Organization (WHO) Mental Health Gap Action Programme (mhGAP) Intervention Guide and case-based discussions is valued by participants and can improve the knowledge, confidence and beliefs of primary care doctors in low- and middle-income countries.


BJPsych Open ◽  
2019 ◽  
Vol 5 (6) ◽  
Author(s):  
Steve Kisely ◽  
Dan Siskind

Summary Mental health is increasingly recognised as an important component of global health. In recognition of this fact, the European Union funded the Emerald programme (Emerging Mental Health Systems in Low- and Middle-Income Countries). The aims were to improve mental health in the following six low- and middle-income countries (LMICs): Ethiopia, India, Nepal, Nigeria, South Africa and Uganda. The Emerald programme offers valuable insights into addressing the mental health needs of LMICs. It provides a framework and practical tools. However, it will be important to evaluate longer-term effects including improvements in mental health outcomes, as well as the applicability to LMICs beyond existing participant countries. Importantly, this must be coupled with efforts to improve health worker retention in LMICs.


2008 ◽  
Vol 192 (5) ◽  
pp. 368-375 ◽  
Author(s):  
Johan Ormel ◽  
Maria Petukhova ◽  
Somnath Chatterji ◽  
Sergio Aguilar-Gaxiola ◽  
Jordi Alonso ◽  
...  

BackgroundAdvocates of expanded mental health treatment assert that mental disorders are as disabling as physical disorders, but little evidence supports this assertion.AimsTo establish the disability and treatment of specific mental and physical disorders in high-income and low- and middle-income countries.MethodCommunity epidemiological surveys were administered in 15 countries through the World Health Organization World Mental Health (WMH) Survey Initiative.ResultsRespondents in both high-income and low- and middle-income countries attributed higher disability to mental disorders than to the commonly occurring physical disorders included in the surveys. This pattern held for all disorders and also for treated disorders. Disaggregation showed that the higher disability of mental than physical disorders was limited to disability in social and personal role functioning, whereas disability in productive role functioning was generally comparable for mental and physical disorders.ConclusionsDespite often higher disability, mental disorders are under-treated compared with physical disorders in both high-income and in low- and middle-income countries.


2013 ◽  
Vol 202 (1) ◽  
pp. 42-49 ◽  
Author(s):  
J. Elisabeth Wells ◽  
Mark Oakley Browne ◽  
Sergio Aguilar-Gaxiola ◽  
Ali Al-Hamzawi ◽  
Jordi Alonso ◽  
...  

BackgroundPrevious community surveys of the drop out from mental health treatment have been carried out only in the USA and Canada.AimsTo explore mental health treatment drop out in the World Health Organization World Mental Health Surveys.MethodRepresentative face-to-face household surveys were conducted among adults in 24 countries. People who reported mental health treatment in the 12 months before interview (n = 8482) were asked about drop out, defined as stopping treatment before the provider wanted.ResultsOverall, drop out was 31.7%: 26.3% in high-income countries, 45.1% in upper-middle-income countries, and 37.6% in low/ lower/middle-income countries. Drop out from psychiatrists was 21.3% overall and similar across country income groups (high 20.3%, upper-middle 23.6%, low/lower-middle 23.8%) but the pattern of drop out across other sectors differed by country income group. Drop out was more likely early in treatment, particularly after the second visit.ConclusionsDrop out needs to be reduced to ensure effective treatment.


2008 ◽  
Vol 5 (2) ◽  
pp. 27-28 ◽  
Author(s):  
John L. Cox

It is perhaps unusual for an academic journal like the Lancet to spearhead a ‘movement’ to advocate the scaling up of mental health services in low-income countries. Yet at the movement's launch in London in November 2007, attended by representatives from World Health Organization (WHO), the World Bank, donor agencies, as well as the World Psychiatric Association (WPA) and the Royal College of Psychiatrists, it was clear that a seminal series of papers, published in September of last year, was of the utmost importance for world psychiatry and for our planet. The five papers in the series ‘Global Mental Health’ had the following titles: ‘No health without mental health’; ‘Resources for mental health: scarcity, equity, and inefficiency’; ‘Treatment and prevention of mental disorders in low-income and middle-income countries’; ‘Mental health systems in countries: where are we now?’; and ‘Barriers to improvement of mental health services in low-income and middle-income countries’ (Lancet, September 2007, vol. 370, nos 9590–9593).


Author(s):  
A. Stickley ◽  
H. Oh ◽  
T. Sumiyoshi ◽  
M. McKee ◽  
A. Koyanagi

Abstract Aims Although injuries have been linked to worse mental health, little is known about this association among the general population in low- and middle-income countries (LAMICs). This study examined the association between injuries and depression in 40 LAMICs that participated in the World Health Survey. Methods Cross-sectional information was obtained from 212 039 community-based adults on the past 12-month experience of road traffic and other (non-traffic) injuries and depression, which was assessed using questions based on the World Mental Health Survey version of the Composite International Diagnostic Interview. Multivariable logistic regression analysis and meta-analysis were used to examine associations. Results The overall prevalence (95% CI) of past 12-month traffic injury, other injury, and depression was 2.8% (2.6–3.0%), 4.8% (4.6–5.0%) and 7.4% (7.1–7.8%), respectively. The prevalence of traffic injuries [range 0.1% (Ethiopia) to 5.1% (Bangladesh)], and other (non-traffic) injuries [range 0.9% (Myanmar) to 12.1% (Kenya)] varied widely across countries. After adjusting for demographic variables, alcohol consumption and smoking, the pooled OR (95%CI) for depression among individuals experiencing traffic injury based on a meta-analysis was 1.72 (1.48–1.99), and 2.04 (1.85–2.24) for those with other injuries. There was little between-country heterogeneity in the association between either form of injury and depression, although for traffic injuries, significant heterogeneity was observed between groups by country-income level (p = 0.043) where the pooled association was strongest in upper middle-income countries (OR = 2.37) and weakest in low-income countries (OR = 1.46). Conclusions Alerting health care providers in LAMICs to the increased risk of worse mental health among injury survivors and establishing effective trauma treatment systems to reduce the detrimental effects of injury should now be prioritised.


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